AIDS InfoNet www.aidsinfonet.org Fact Sheet Number 401A TAKING CURRENT ANTIRETROVIRAL DRUGS: Part A: NUCLEOSIDE, NUCLEOTIDE AND NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS DRUG DAILY PILLS (ADULTS)* Abacavir (Ziagen) 2 (300 mg: 1, 2x/day or 2, 1x/day) Non-nukes (NNRTIs)** Nucleoside Analog Reverse Transcriptase Inhibitors (NRTIs) Combivir (Combination pill) Didanosine (ddI, Videx, Videx-EC) 2 (150 mg lamivudine + 300 mg zidovudine: 1, 2x/day) Buffered tablet: 4 (100 mg: 2, 2x/day or 4, 1x/day) Videx-EC: 1 pill daily; patients over 60 kg/132 lbs; 250 mg if below. HOW TO TAKE & STORE No food restrictions; alcohol boosts abacavir levels. SIDE EFFECTS Hypersensitivity reaction in about 8% of patients Anemia, nausea, vomiting, headache, fatigue, muscle aches, bone marrow toxicity, NOTES Don’t use with just two other nucleoside analogs unless additional drugs are used. Chew or dissolve in water; take on empty stomach; not within 1 hour of indinavir or 2.5 hours of ritonavir. Diarrhea, pancreatitis, abdominal pain, neuropathy, nausea & vomiting Don’t combine with stavudine (d4T). Check with your health care provider if taking tenofovir. Do not take with lamivudine (Epivir) or Truvada. No food restrictions. Do not take with zidovudine, stavudine or lamivudine Emtricitabine (FTC, Emtriva) 1 (200 mg; 1, once a day) No food restrictions. Headache, diarrhea, nausea, and rash. Epzicom (Combination pill) 1 (600 mg abacavir + 300 mg 3TC: 1, 1x/day) No food restrictions. Nausea, vomiting, fatigue, headaches Lamivudine (3TC, Epivir) 2 (150 mg: 1, 2x/day) or 1 (300 mg; 1, 1x/day) No food restrictions. Nausea, vomiting, fatigue, headaches. Stavudine (d4T, Zerit) 2 (40 mg for people over 60 kg/132 lbs body weight, 30 mg if below; 1, 2x/day) No food restrictions. Tenofovir (Viread) 1 (300 mg: 1, 1x/day) No food restrictions. Trizivir (Combination pill) 2 (150 mg lamivudine + 300 mg zidovudine + 300 mg abacavir: 1, 2x/day) No food restrictions. See zidovudine (Retrovir), lamivudine (Epivir) and abacavir (Ziagen) above. Do not take with abacavir (Ziagen), emtricitabine (Emtriva), lamivudina (Epivir), stavudine (Zerit), or zidovudine (Retrovir) . Truvada (Combination pill) Zalcitabine (ddC, Hivid) 1 (300 mg tenofovir + 200 mg emtricitabine: 1, 1x/day) No food restrictions Headache, nausea, vomiting, rash, loss of appetite. Do not take with ddI (Videx), emtricitabine (Emtriva) or lamivudina (Epivir). Zidovudine (AZT, Retrovir) 6 (100 mg: 2, 3x/day) or 2 (300 mg: 1, 2x/day) Delavirdine (Rescriptor) 12 (100 mg; 4, 3x/day) or 6 (200 mg; 2, 3x/day) Efavirenz (Sustiva) 3 (200 mg; 3, 1x/day) or 1 (600 mg; 1, 1x/day) Etravirine (Intelence) Nevirapine (Viramune) 4 (100 mg, 2, 2x/day) 1 (200 mg; 1, 1x/day for the first two weeks) then 2 (200 mg; 1, 2x/day) 1 (25 mg, 1, 1x/day) Rilpivirine (Edurant) Peripheral neuropathy, headache, chills & fever, diarrhea, nausea, fat loss in arms, legs or face. Mild side effects; some nausea, vomiting, loss of appetite. May decrease bone mineral density. Blood levels may be increased by bactrim/septra; don’t take with (emtricitabine (FTC) or Zerit, d4T;) don't combine with just two other nucleoside analogs unless additional drugs are used. Can reduce resistance to AZT. Don’t combine with just two other nucleoside analogs unless additional drugs are used. Don’t combine with zidovudine (Retrovir) or didanosine (Videx.) Don’t combine with ddI. Don’t combine with just two other nucleoside analogs unless additional drugs are used. Don't take with Truvada. Manufacture terminated in 2006 No food restrictions. No food restrictions. 100 mg pills can be dissolved in water. Take one hour apart from ddI or antacids. Take on an empty stomach before going to sleep. Anemia, nausea, vomiting, headache, fatigue, muscle aches, bone marrow toxicity Skin rash, nausea, diarrhea, vomiting, headache, fatigue Take after a meal No food restrictions. Vivid dreams, anxiety, rash, nausea, dizziness, diarrhea, headache and insomnia Rash, nausea, abdominal pain Skin rash, fever, headache, nausea. Take with a meal Depression, insomnia, headache, rash Don’t combine with d4T May cause false positive result on test for marijuana use. Watch for liver problems, especially if starting with higher CD4 counts. **NNRTIs are metabolized by the liver, as are many other drugs. Be sure your health care provider knows about all other drugs and supplements you are taking. *These pill counts reflect the “normal” use of each drug. However, antiretroviral medications are being combined in new ways. Doses of each drug may be higher or lower in the new combinations. A Project of the International Association of Providers of AIDS Care. Fact Sheets can be downloaded from the Internet at http://www.aidsinfonet.org AIDS InfoNet www.aidsinfonet.org Fact Sheet Number 401B TAKING CURRENT ANTIRETROVIRAL DRUGS: Combination therapy Part B: COMBINATION THERAPY, PROTEASE, FUSION AND INTEGRASE INHIBITORS DRUG Atripla (emtricitabine + tenofovir + efavirenz) Complera (emtricitabine + rilpivirine + tenofovir DAILY PILLS (ADULTS)* 1 (600 mg efavirenz + 200 mg emtricitabine + 300 mg tenofovir, 1x/day) 1 (200 mg emtricitabine + 25 mg rilpivirine + 300 mg tenofovir) HOW TO TAKE & STORE Take on an empty stomach before going to sleep. Take with a meal SIDE EFFECTS Vivid dreams, anxiety, rash, nausea, dizziness, diarrhea, headache and insomnia, vomiting, loss of appetite Depression, insomnia, headache, rash, diarrhea, vomiting Stribild (emtricitabine + tenofovir + elvitegravir + cobicistat) 1 (150 mg elvitegravir,+ 150 mg cobicistat + 200 mg of emtricitabine, + 300 mg of tenofovir) 1 (50 mg dolutegravir + 600 mg abacavir + 300 mg lamivudine) Take with food; 2 hours apart from antacids. Headache, diarrhea, nausea, vomiting, vivid dreams, anxiety, rash, dizziness, insomnia, and loss of appetite. Loss of bone mineral density Diarrhea, nausea and headache. Triumeq (dolutegravir+abacavir+lamivudin e) Amprenavir (Agenerase) Atazanavir (Reyataz) Darunavir (Prezista) Protease Inhibitors Fosamprenavir (Lexiva) Indinavir (Crixivan) Lopinavir/ritonavir (Kaletra, Aluvia) Nelfinavir (Viracept) Ritonavir (Norvir) Saquinavir (Invirase) Tipranavir (Aptivus) No food restrictions. Take with food if also taking multivitamins or certain antacids or supplements. NOTES May cause false positive result for marijuana Should not be initiated in people with viral loads over 100,000 copies/mL Should not be started in people with severe kidney injury. Genetic screening for abacavir allergy should be performed. Manufacture terminated in 2007. Replaced by fosamprenavir (see below). 2 (300 mg, 1 + 1 ritonavir 100 mg once a day or 2 (200 mg, once a day) 6 (300 mg; 2 + 1 ritonavir, twice a day) or 4 (600 mg + 1 ritonavir, twice a day) 4 (700 mg; 2, twice a day) or 4 (700 mg, 2 + 2 ritonavir, once a day; or 700 mg, 1 + 1 ritonavir twice a day) 6 (400 mg: 2, every 8 hrs, not 3x/day) or 9 (333 mg; 3 every 8 hours) 4 (200 mg lopinavir + 50 mg ritonavir: 2, 2x/day) 9 (250 mg; 3, 3x/day) or 10 (5, 2x/day) or 4 (625 mg; 2, 2x/day) 12 (100 mg: 6, 2x/day); small doses used to boost other protease inhibitors 6 (500 mg: 2 + 1 100 mg ritonavir, 2x/day) 8 (250 mg, 2 + 2 ritonavir 100 mg, twice a day) Take with food. Take with food. High bilirubin. Nausea, headache, rash, stomach pain, vomiting, diarrhea, tingling in hands or feet, and depression. Changes in heart rhythm. Diarrhea, nausea, headache, and a common cold. Some people may get a skin rash. In rare cases, this could be serious. No food restrictions. Nausea, diarrhea, vomiting, rash, numbness around mouth, abdominal pain. Increase in cholesterol and triglycerides. Take with lots of water, on empty stomach or with low-fat snack. Keep cool and dry. Headache, nausea, abdominal pain, kidney stones. No food restrictions for tablets; take liquid with food. Keep at room temperature. Diarrhea, fatigue, headache, nausea. Increase in cholesterol and triglycerides. Take with meals or a snack. Diarrhea, nausea, gas, abdominal pain, weakness. Take with food if possible. Keep refrigerated. Take 2 hours apart from ddI. Nausea, vomiting, diarrhea, tingling & numbness around mouth. Increase in cholesterol and triglycerides. Take within two hours of a full meal or large snack. In hot climates, keep refrigerated. Minimal nausea, diarrhea, abdominal discomfort. Take with food. Refrigerate, or keep at room temperature up to 60 days. Diarrhea, rash, nausea, vomiting, stomach pain, tiredness and headache. Worsening of liver problems. Increase in cholesterol and triglycerides. A Project of the International Association of Providers of AIDS Care. Fact Sheets can be downloaded from the Internet at http://www.aidsinfonet.org Protease inhibitors are metabolized by the liver, as are many other commonly used drugs. Drug interactions can cause large increases or decreases in the blood levels of drugs you are taking. Interactions can cause under-doses that are ineffective, or overdoses that can be fatal. Make sure your health care provider knows about all medications and supplements you are taking. AIDSInfoNet www.aidsinfonet.org Fact Sheet Number 401B TAKING CURRENT ANTIRETROVIRAL DRUGS: Part B: COMBINATION THERAPY, PROTEASE, FUSION AND INTEGRASE INHIBITORS (continued) Enfuvirtide (Fuzeon) Fusion Inhibitors Integrase Inhibitor Maraviroc (Selzentry, Celsentri) Raltegravir (Isentress) 2 injections each day. 90 mg per injection for adults. 1 or 2 tablets twice each day. 150, 300 or 600 mg per tablet. 2 tablets (400 mg, 1, 2x/day) No food restrictions. No food restrictions. No food restrictions. Skin reactions where drug is injected ranging from redness and itching to hard lumps. Cough, fever, upper respiratory infections, rash, sore muscles, abdominal pain, and dizziness. Can be hard on the liver. Dosage depends on other medications being taken. Diarrhea, nausea and headache; elevated levels of creatine kinase (relates to muscle problems) Dosed 50 mg 1, 2 x/day in patients with suspected integrase inhibitor resistance These pill counts reflect the “normal” use of each drug. However, antiretroviral medications are being combined in new ways. Doses of each drug may be higher or lower in the new combinations. Dolutegravir (Tivicay) 1 tablet (50 mg, 1, 1x day) No food restrictions. Take with food if also taking multivitamins or certain antacids or supplements. Insomnia, headaches Revised September 26, 2014 A Project of the International Association of Providers of AIDS Care. Fact Sheets can be downloaded from the Internet at http://www.aidsinfonet.org